COVID-19肝损害的临床和实验室特征

S. A. Chernyak
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引用次数: 0

摘要

背景具有多系统作用的СOVID-19会导致肝脏功能紊乱。客观的评估新冠肺炎患者在不同SARS-CoV2毒株循环期间的肝脏功能状态。材料和方法。研究对象是在格罗德诺地区传染病临床医院住院的180名新冠肺炎患者。患者被分为两组:第一组(n=51)——在奥密克戎毒株循环期间(2022年)接受检查的患者,第二组(n=129)——在2020-2021年期间(在先前毒株循环期间)接受治疗的患者。实验室分析包括对生化和超声参数的评估。后果在第一组中,消化不良综合征、高胆红素血症和低白蛋白血症更常见。根据天冬氨酸转氨酶(AST)水平,第二组患者有更明显的严重呼吸衰竭表现,同时伴有更明显的高酶血症。结论。高胆红素血症和低白蛋白血症在奥密克戎毒株的循环过程中更为常见,可被视为急性混合病因反应性肝炎的一种表现。在其他菌株的循环过程中,AST引起的高酶血症的主要原因可能是病毒的细胞病变作用和药物诱导的肝损伤。
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CLINICAL AND LABORATORY CHARACTERISTICS OF LIVER DAMAGE IN COVID-19
Background. Having its multisystemic effect СOVID-19 leads to liver disfunction. Objective. To assess the functional state of the liver in patients with COVID-19 during the periods of circulation of different SARS-CoV 2 strains. Material and methods. The object of the study was 180 patients with COVID-19 who were hospitalized at Grodno Regional Infectious Diseases Clinical Hospital. The patients were divided into two groups: the 1st group (n=51) - those examined during the circulation of the Omicron strain (2022), the 2nd (n=129) – the patients who were treated over 2020-2021 (during the circulation of previous strains). The laboratory analysis included the assessment of biochemical and sonographic parameters. Results. In the first group, dyspeptic syndrome, hyperbilirubinemia and hypoalbuminemia were more often recorded. The patients of the second group had more pronounced manifestations of severe respiratory failure alongside with significantly more pronounced hyperenzymemia according to aspartate aminotransferase (AST) level. Conclusions. Hyperbilirubinemia and hypoalbuminemia, being significantly more common during the circulation of the Omicron strain, may be regarded as a manifestation of acute mixed-etiology reactive hepatitis. The predominance of hyperenzymemia due to AST during the circulation of other strains may be accounted for by the cytopathic effect of the virus and drug-induced liver damage.
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